Healthcare Provider Details

I. General information

NPI: 1417127374
Provider Name (Legal Business Name): DAOIST INSTITUTE OF HEALING ARTS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2008
Last Update Date: 10/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 SW 2ND ST
CORVALLIS OR
97333-4884
US

IV. Provider business mailing address

2459 SE MICAH PL
CORVALLIS OR
97333-1965
US

V. Phone/Fax

Practice location:
  • Phone: 541-257-2140
  • Fax:
Mailing address:
  • Phone: 541-908-5413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC01156
License Number StateOR

VIII. Authorized Official

Name: MR. ISAAC C HENDLER
Title or Position: PRESIDENT
Credential: MAC., LAC
Phone: 541-908-5413